Biological and clinical correlates after chemotherapy and granulocyte colony-stimulating factor administration.
OBJECTIVE
To evaluate specific biological markers to improve understanding and use of granulocyte colony-stimulating factor (G-CSF) in patients receiving chemotherapy


METHODS
Prospective, randomized study.


METHODS
University-affiliated hospital and cancer center.


METHODS
Twenty-five patients randomized to begin G-CSF either 24 hours after chemotherapy (standard arm), or on the day the absolute neutrophil count (ANC) was below 1000/mm3 after chemotherapy (delayed arm).


METHODS
To determine the effect of G-CSF on granulopoiesis, peripheral blood mononuclear cells were assayed by semisolid culture medium and flow cytometry for granulocyte progenitors and clonogenic CD34 antigen-positive cells. These biological markers were correlated with G-CSF administration schedules and the ANC.


RESULTS
The effect of timing of G-CSF administration on rate of neutrophil recovery, duration of neutropenia, length of G-CSF therapy, delays of chemotherapy cycles, and neutropenic fever events was evaluated. Regardless of G-CSF schedule or chemotherapy regimen, the appearance of mobilized hematopoietic progenitors begins at the neutrophil nadir and parallels granulocyte recovery. Our data also demonstrate that proper timing of G-CSF administration produces similar rates of neutrophil recovery and comparable clinical outcomes.


CONCLUSIONS
Based on the correlation between biological markers and ANC, we propose that the postchemotherapy ANC is a surrogate marker of renewed granulopoietic activity. The relevance of this finding in relationship to the clinical application of G-CSF remains to be further defined.
Higa
G M
GM
Department of Pharmacy Practice, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, USA.
DeVore
R F
RF
Auber
M L
ML
Lynch
J P
JP
Landreth
K S
KS
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000097:blood*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D009504:Neutrophils; D011446:Prospective Studies
D018952:Antigens, CD34; D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor